目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

目的 探讨无痛消化内镜下高频电刀治疗对胃癌前病变的应用效果及复发率的影响。方法 选取甘肃医学院附属医院2017年1月—2020年1月收治的120例胃癌前病变患者进行回顾性分析,依照其手术治疗方案将其分为两组,各60例。对照组采取常规内镜黏膜下剥离术,观察组患者采取无痛消化内镜下高频电刀剥离治疗。对比两组的切除速度、切除面积、治愈性切除率、完全及整块切除率,对患者进行3年随访,记录其复发情况,并对比两组患者并发症情况。结果 两组的切除面积、治愈性切除率、完全切除率及整块切除率对比差异无统计学意义（P>0.05）,观察组切除速度为（27.34±8.58）mm²/min,高于对照组的（15.54±4.52）mm²/min,差异有统计学意义（P<0.05）。两组患者术后3年的总复发率（28.33% vs 30.00%）对比差异无统计学意义（P>0.05）。观察组感染、穿孔等相关并发症发生率为3.33%,低于对照组的15.00%（P<0.05）。结论 无痛消化内镜下高频电刀与常规内镜黏膜下剥离术治疗胃癌前病变相比具有显著疗效。但无痛消化内镜下高频电刀治疗可提升切除速度,降低并发症发生率。

Objective To explore the application effect and recurrence rate of painless endoscopic high-frequency electrocautery on gastric precancerous lesions．Methods A total of 120 patients with precancerous gastric cancer admitted to the Affiliated Hospital of Gansu Medical College from January 2017 to January 2020 were selected for retrospective analysis and divided into two groups according to their surgical treatment plan,with 60 patients in each group．The control group underwent conventional endoscopic submucosal dissection,and the patients in the observation group received painless digestive endoscopic high-frequency electric knife dissection．The resection speed,resection area,curative resection rate,complete and bulk resection rate were compared of the two groups,the patients were followed up for 3 years to record the recurrence rate,and the complications of the two groups of patients were also compared．Results There were no differences in resection area,curative resection rate,complete resection rate and total resection rate between the two groups（P>0.05）．The resection speed in the observation group was（27.34±8.58）mm²/min,which was higher than that in the control group（15.54±4.52）mm²/min（P<0.05）．There was no difference in the total recurrence rate（28.33% vs 30.00%）at 3 years after surgery between the two groups（P>0.05）．The incidence of infection,perforation and other related complications in the observation group was 3.33%,lower than that in the control group（15.00%）（P<0.05）．Conclusion sCompared with conventional endoscopic submucosal dissection,high-frequency electric knife under painless digestive endoscopy has significant efficacy in the treatment of gastric precancerous lesions．However,painless endoscopic high-frequency electrosurgical treatment can improve the resection speed and reduce the incidence of complications such as infection,perforation and bleeding．

目的 通过多种生物信息学方法分析MAML1在GC患者中的表达及与临床特征、预后和免疫治疗疗效的相关性。方法 利用TCGA数据库分析胃癌组织与正常胃黏膜组织中的MAML1表达水平;Kaplan-Meier在线工具对胃癌数据集GSE15459进行分析,阐明MAML1与患者临床特征及分期、治疗疗效的相关性;STRING软件预测与MAML1表达相关的基因,并用FUNRICH软件评估其富集的分子生物学功能和信号通路;TIMER和GEPIA数据库探索MAML1表达水平与肿瘤浸润免疫细胞及其相应基因标记集之间的关系。结果 MAML1在GC组织中的表达水平高于正常组织(P<0.001),且其表达水平与III期、有淋巴结转移、无远处转移的患者生存期相关(P<0.05),而与I、II和IV期、无淋巴结转移和有远处转移的患者生存期无相关性(P>0.05)。MAML1的相关作用基因主要分布在细胞核、参与转录调控,并且主要富集在雄激素受体、C-MYB转录因子和HIF-2α转录调控等相关的信号通路。MAML1表达水平与B细胞、CD4⁺ T细胞、巨噬细胞的表达水平存在正相关关系(P<0.05),但与肿瘤纯度、CD8⁺ T细胞、中性粒细胞、树突状细胞无相关性(P>0.05)。结论 MAML1有可能成为GC患者较差的临床预后标志物之一,其潜在分子机制可能与转录调控调节肿瘤微环境有关。

Objective To investigate the expression of MAML1 and its relationship with clinical characteristics, prognosis and the efficiency of immunotherapy in patients with GC. Methods MAML1 expression profile was observed by TCGA database. Kaplan-Meier survival analysis was applied to evaluate the correlation between the expression of MAML1 and clinical characteristics, prognosis and treatment efficiency of patients in GSE15459 dataset. MAML1-associated genes were predicted by STRING and were enriched in GO and KEGG by FUNRICH software. The relationship between MAML1 expression and markers of tumor infiltrated cells were explored by TIMER and GEPIA database. Results MAML1 was abnormally upregulated in GC tissues compared to normal gastric tissues (P<0.001). MAML1 expression was significantly associated with the overall survival of patients in stage III, with lymph node metastasis and without distant metastasis (P<0.001). There was no significant difference between MAML1 expression and the overall survival of patients in stage I, II, IV, without lymph node metastasis and with distant metastasis (P>0.05). MAML1-assoicated genes were mainly located at the nucleus, mediating transcriptional regulation and mainly enriching in androgen receptor, C-MYB transcription factor and HIF-2α transcription regulation and other related signaling pathways. MAML1 expression was positively related with the expression of B cell, CD4⁺ T cell and macrophages (P<0.05), but without significant difference with tumor purity, CD8⁺ T cell, neutrophils and dendritic cells (P>0.05). Conclusions MAML1 could be used as a marker of clinical prognosis of patients with GC. The potential molecular mechanism might be associated with its function in transcriptional regulation and changes in tumor microenvironment.

目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况（CONUT）评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组（P=0.005 3）,且2组性别构成存在差异,男性患者多于女性（P=0.037 0）。CONUT评分>2.5组患者的肿瘤直径较大（P=0.039 4）。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组（P=0.008 3）。单因素Logistic回归分析,年龄（OR=1.127;95%CI：1.028~1.236;P=0.011）、CONUT评分（OR=0.339;95%CI：0.151~0.764;P=0.009）是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄（OR=1.115;95%CI：1.008~1.233;P=0.035）、CONUT评分（OR=0.414;95%CI：0.175~0.982;P=0.045）是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。

Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer．Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed．Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status（CONUT）score was calculated．The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated．Results A total of 223 patients were included in this study．The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter．The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5（P=0.005 3）．Moreover,there was significant difference between the sex ratio of the two groups,with male more than female（P=0.037 0）．The tumor diameter was significantly larger in the group with CONUT score > 2.5（P=0.039 4）．In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5（P=0.008 3）．Univariate logistic regression analysis showed that age（OR=1.127;95% CI：1.028-1.236;P=0.011）and CONUT score（OR=0.339;95% CI：0.151-0.764;P=0.009）were the risk factors for short-term complications．Multivariate logistic regression analysis showed that age（OR=1.115;95% CI：1.008-1.233;P=0.035）and CONUT score（OR=0.414;95% CI：0.175-0.982;P=0.045）were the risk factors for short-term complications．Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications．

目的 分析在胃癌诊断中应用人表皮生长因子受体2（HER-2）结合肿瘤标志物检测的意义。方法 回顾性选取2019年6月—2021年6月我院收治的100例胃癌患者作为胃癌组,另选同期收治的60例胃良性肿瘤患者作为胃良性肿瘤组。比较HER-2与多项肿瘤标志物检测的诊断效能等。结果 胃癌组HER-2、糖类抗原（CA）125、CA72-4及CA19-9浓度与阳性表达率高于胃良性肿瘤组（P<0.05）。对于胃癌诊断,免疫组化指标HER-2检测的敏感度为72.00%,正确率为77.00%;多项肿瘤标志物检测的敏感度为77.00%,正确率为80.00%;二者联合检测的敏感度为89.00%,正确率为90.00%;相较于多项肿瘤标志物与HER-2单一检测,二者联合检验的正确率、敏感度更高（P<0.05）。结论 HER-2结合血清肿瘤标志物检验对胃癌的诊断价值较高。

Objective To analyze the significance of human epidermal growth factor receptor 2（HER-2）combined with tumor marker in the diagnosis of gastric cancer．Methods A total of 100 patients with gastric cancer admitted to our hospital from June 2019 to June 2021 were retrospectively selected as the gastric cancer group, and 60 cases of gastric benign tumor admitted to our hospital during the same period were also selected．The diagnostic efficacy of HER-2 was compared with those of multiple tumor markers．Results The concentration and positive expression rate of HER-2, carbohydrate antigen（CA）125, CA72-4 and CA19-9 in gastric cancer group were higher than those in gastric benign tumor group（P<0.05）．For the diagnosis of gastric cancer, the sensitivity of the immunohistochemical indicator HER-2 detection was 72.00%, and the accuracy rate was 77.00%．The sensitivity and accuracy of detecting multiple tumor markers were 77.00% and 80.00%, respectively．The sensitivity of the combined detection of the two was 89.00%, and the accuracy was 90.00%．Compared to multiple tumor markers and HER-2 single detection, the combined test of the two had a higher accuracy and sensitivity（P<0.05）．Conclusions The detection of HER-2 combined with serum tumor markers has high diagnostic value for gastric cancer．

目的 探讨胃癌误诊为环状胰腺并胰腺炎并十二指肠梗阻的原因和治疗。方法 对本院收治的1例由胃癌误诊为环状胰腺并胰腺炎以及十二指肠梗阻患者的临床情况加以总结,并总结复习和分析相关文献。结果 本例患者虽最终明确诊断为胃癌,但病理提示分化差,合并全身多处骨转移,疾病进展迅速,后续放化疗效果欠佳。早期诊断、早期治疗是影响胃癌患者预后的关键。结论 胃癌骨转移的发病率低,极少进行骨转移评估,易造成误诊。当出现胃十二指肠流出道梗阻时,虽患者合并环状胰腺,仍需警惕胃癌的可能,及早完善全身检查,明确诊断,采取正确的治疗措施。

目的 分析团体认知行为干预联合揿针全程护理对胃癌晚期癌痛患者心理状态的影响。方法 选取我院115例胃癌晚期癌痛患者(2018年3月—2021年1月),依照干预方案不同分为3组。对照1组(37例)接受团体认知行为干预,对照2组(38例)接受揿针全程护理干预,观察组(40例)接受团体认知行为干预联合揿针全程护理干预,比较3组干预效果。结果 疼痛爆发时疼痛缓解情况:观察组疼痛爆发时疼痛缓解率均较对照1组、对照2组高(P＜0.05);心理状态:干预1个月后,3组心理状态均得到改善,且观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均较对照1组、对照2组低(P＜0.05);护理满意度:与对照1组、对照2组对比,观察组护理满意度较高(P＜0.05)。结论 团体认知行为干预联合揿针全程护理应用于胃癌晚期癌痛患者,能有效缓解疼痛,改善心理状态,且护理满意度高。

Objective To analyze the effect of group cognitive behavior intervention combined with whole-process nursing of pressing needle on the psychological state of patients with advanced gastric cancer pain. Methods A total of 115 patients with advanced gastric cancer pain in our hospital (from March 2018 to January 2021) were selected and divided into 3 groups according to different intervention methods. Control group 1 (37 cases) received group cognitive behavioral intervention, control group 2 (38 cases) received whole-course nursing intervention of pressing needle, and observation group (40 cases) received whole-process nursing intervention of group cognitive behavioral intervention combined with pressing needle. The intervention effects of the three groups were compared. Results Pain relief when pain burst: the pain relief rate of observation group was higher than control group 1 and control group 2 (P<0.05). Mental state: after 1 month of intervention, the mental state of the 3 groups was improved, and the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the observation group were lower than those in control group 1 and control group 2 (P<0.05). Nursing satisfaction: compared with control group 1 and control group 2, nursing satisfaction of observation group was higher (P<0.05). Conclusions Group cognitive behavior intervention combined with whole-process nursing of pressing needle applied to patients with advanced gastric cancer pain could effectively relieve pain, improve psychological state, and nursing satisfaction.

目的 探讨三维超声技术对胃癌检出及TNM分期的诊断价值。方法 取2015年2月—2017年9月河南省南阳市中心医院收治的89例胃癌患者作为研究对象,并对其进行术前二维超声(2D-US)、三维超声(3D-US)检查,观察患者体内肿瘤病灶形态、长径及病变浸润程度,同时根据2010年国际抗癌联盟(UICC)制定的TNM分期标准预测胃癌分期,并将预测分期结果与术后病理分期结果进行比较。结果 89例胃癌患者中,胃体癌22例,胃窦癌28例,贲门胃底癌17例,全胃癌22例;其中,黏液腺癌16例,低分化腺癌26例,中高分化腺癌35例,未分化癌12例;TNM分期:T1期18例,T2期25例,T3期31例,T4期15例。3D-US胃癌检出准确率(95.51%)高于2D-US(80.90%),差异有统计学意义(P＜0.05);3D-US检出胃癌T1期准确率(94.12%)高于2D-US(53.33%)(P＜0.05);3D-US检出胃癌T2期准确率(95.83%)高于2D-US(70.00%)(P＜0.05);3D-US检出胃癌T3期准确率(100.00%)高于2D-US(81.48%)(P＜0.05);3D-US检出胃癌T4期准确率(100.00%)高于2D-US(60.00%)(P＜0.05)。结论 3D-US图像清晰、直观、立体感强,可充分显示2D-US不能显示的肿瘤立体结构,从而提高胃癌检出准确率和术前TNM分期预测准确率,临床推广应用价值较高。